Systems and methods for controlling position

ABSTRACT

Systems and methods for assessing compliance with position therapy. In an embodiment, position therapy is provided to a user while the user is wearing a position therapy device. The position therapy comprises, by the device, collecting positional data, determining positions of the user over a time period based on the positional data, and, when it is determined that the user is in a target position, providing feedback to the user to influence the user to change to a non-target position. In addition, the device stores a duration of use in its memory. The duration of use indicates a duration that the user has used the wearable position therapy device in each of one or more positions. An assessment of the user&#39;s compliance with the position therapy is then provided based, at least in part, on the duration of use.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No.15/825,772, filed on Nov. 29, 2017, which is a continuation of U.S.patent application Ser. No. 14/313,213, filed on Jun. 24, 2014, now U.S.Pat. No. 9,855,006, which is a continuation of U.S. patent applicationSer. No. 12/794,498, filed on Jun. 4, 2010, now U.S. Pat. No. 8,783,264,which claims the benefit of U.S. Provisional Patent App. No. 61/184,631,filed on Jun. 5, 2009, all of which are hereby incorporated herein byreference in their entireties.

BACKGROUND Field of the Invention

The present invention generally relates to the field of treating sleepdisorders and more specifically to systems and methods using positiontherapy (PDT) to treat sleep disorders.

Description of Related Art

Sleep disordered breathing which results in the diagnosis of ObstructiveSleep Apnea (“OSA”) occurs as a result of a partial or complete collapseof the upper airway during sleep. Snoring is the first indication of anairway susceptible to collapse and can lead to inspiratory flowlimitation. Greater obstruction resulting in a partial collapse of theairway causes hypopneas and recognizable changes in tidal volume. Fullcollapse results in a cessation in breathing, events commonly referredto as apneas. The apnea/hypopnea index (AHI) is the measure used todefine OSA severity and is based on the total number of sleep disorderedbreathing events per hour of sleep.

When a patient with OSA is in the supine position, gravity increases thesusceptibility of the airway to partial or full collapse during sleep.The most frequently cited effect of gravity on the soft tissue of thepharynx is tendency of the tongue to fall back against the palatecausing the narrowing of an already compromised airway. A susceptibleairway, by way of example, may result in loud snoring in the supineposition and limited or no snoring the non-supine position. A morecompromised airway may exhibit loud snoring in the non-supine positionand repeated hypopneas (partial collapse) or apneas (full collapse) inthe supine position. This pattern is typically associated with patientswith ‘positional’ sleep disordered breathing. In patients with severelycompromised airways, known as ‘non-positional’ OSA, the pharynx maypartially collapse during non-supine sleep and fully collapses in thesupine position. The influence of gravity during supine sleepcontributes to a reduction in lung volume and oxygen stores andcontributes to increased levels of oxygen desaturation duringobstructive breathing.

Evidence suggest that patients with positional and non-positional OSAform two distinct but overlapping etiologies in which airway length andcraniofacial features influence genioglossal responsiveness to negativepressure pulses in the lateral position. Estimate of the prevalence ofpositional OSA (i.e., the supine AHI is at least two times greater thanthe non-supine AHI) among all those diagnosed with OSA range from 55 to65%), and after excluding those who sleep almost exclusively on theirback (e.g., >95% of the night), over 50% of patients diagnosed withsleep could reduce their AHI by at least 50% and/or into a normal rangeby avoiding sleep in the supine position. Studies have shown thatposition therapy can contribute to a significant drop in blood pressurein patients with Obstructive Sleep Apnea (OSA) because supine sleepincreases the severity of OSA. Position therapy can be combined withother therapies to enhance outcomes in the treatment of sleep disorderedbreathing. Several investigators have demonstrated nasal continuouspositive airway pressure (CPAP) pressures can be reduced if patientssleep lateral instead of supine and increased CPAP compliance has beenassociated with lower pressures.

A plethora of shirts, vests, belts, pillows and other inventions haveattempted to address the need for positional therapy to reduce theseverity of snoring or sleep apnea by using mechanical means thatessentially makes it uncomfortable for a user to sleep supine. Someexamples of these devices include a knapsack stuffed with Styrofoam toprovide a bulky alternative to tennis balls, which makes it impossibleto sleep supine. At least one study has demonstrated that this type ofposition restriction provides limited to no clinical efficacy due tonon-compliance. The greatest limitation of these approaches is that thetherapy is initiated prior to the patient falling asleep. As shown withCPAP therapy, patients are much more tolerant of therapy if it isinitiated after the patients have fallen asleep.

The number of electronic devices invented to limit supine sleep issubstantially less. One device, described in U.S. Pat. No. 5,081,447,employs the use of two gravity position sensors and an audio alarm totrigger the user to change position. One of the limitations of thisapproach is a bed-partner of the user would also be awakened each timethe alarm is triggered. An alternative approach, described in U.S. Pat.No. 5,381,801, limits supine sleep by applying electromechanicalvibration using motors inserted into pockets of a belt worn by a user.Application of the tactile stimulus is dependent on the closing of anelectronic switch within the pocket of the belt that is triggered bycontact with the underlying surface of the sleeper.

Positional therapy holds the potential to provide important therapeuticbenefit for a number of medical conditions. For example, over 63% ofpatients with acute ischemic stroke sleep the entire night in the supineposition. Sleep in the supine position also increases the severity ofCheyne-Stokes i.e., respiration i.e., central sleep apnea. Avoidingsupine sleep during the second and third trimesters of pregnancy wouldreduce pressure on a vena cava vein and improve blood flow to the fetus.An adjustment in the application of position feedback would assistpatients recovering from hip surgery avoid sleep in the non-supineposition. The measurement of and feedback related to the position of theelements of the body (e.g., arm, leg, hand, wrist, ankle, knee, etc.)could be useful in injury rehabilitation or in training or performancewhich requires the user to find or maintain a specific position/posture.Thus, the potential benefit of positional therapy is clear, butconventional systems and methods to affect or influence sleep positionhave been largely ineffective.

SUMMARY

Systems and methods for controlling the position of a user of a wearablepositional therapy device are provided. In one embodiment, the wearableposition therapy device is configured to monitor and store physiologicalsignals that can be used to assess sleep quality and sleeping positionof a user as well as during other activities. The device can beconfigured to be worn around the head, the neck, or body of the userand/or can comprise of more than one unit that are connected wirelesslyto share information. The device can be configured to provide feedbackto a user if the user is sleeping or is positioned in a target positionto induce the user to change positions. For example, the device can beconfigured to limit the amount of time that the user spends sleeping ina supine position for users for whom it is not recommended to sleep in asupine position, such as OSA patients and users who are pregnant. Thefeedback can be provided by one or more haptic motors that can beconfigured to provide various levels of feedback and the level offeedback can be customized based on the user's reaction to the feedback.

In an embodiment, a wearable position therapy device for influencing theposition of a user is provided. The device includes a position detectorconfigured to generate positional signal data that can be used todetermine a position of the user, a haptic feedback device configured togenerate tactile feedback to the user of the device, and amicrocontroller. The microcontroller is configured to receive andanalyze the signal data from the position detector, determine whetherthe user of the device is in a target position, and generate a controlsignal to cause the haptic feedback device to provide tactile feedbackto the user to induce the user to change to a different, non-targetposition if the user of the device is in a target position. In anembodiment, the position therapy device can be configured to influence asleeping position of a user and can be worn while the user sleeps. Thetarget position can be a target sleep position, and the microcontrollercan be configured to generate a control signal to cause the hapticfeedback device to provide tactile feedback to the user to induce theuser to change to a different, non-target sleep position if the user ofthe device is in a target sleep position.

In another embodiment, a method for influencing the position of a userusing a wearable position therapy device is provided. The methodincludes applying the position therapy devices to the head, neck, body,torso, hand, wrist or knee of the user, collecting positional signaldata to determine a position and manner of the user while the user iswearing the device, determining whether the positional signal dataindicates that the user is positioned in a target position, andgenerating haptic feedback to the user to induce the user to change to adifferent, non-target position if the user is in the target position. Inan embodiment, the method can be used to influence a sleeping positionof a user of the wearable position therapy device, and the positionalsignal data can be used to determine whether the user is in a targetsleep position, and to provide haptic feedback to the user if the useris in the target sleep position to influence the user to change to adifferent, non-target sleep position.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 identifies the primary electronic components and circuits of aposition therapy device configure to monitor and reduce sleep in atarget position according to an embodiment;

FIG. 2 is a flow diagram of a basic approach to reduce sleep in a targetposition using a the position therapy device illustrated in FIG. 1 toprovide haptic feedback to induce a user to change sleep positionsaccording to an embodiment;

FIG. 3 illustrates another method for monitoring and influencing thesleep position using the position therapy device of FIG. 1 to providehaptic feedback to induce a user to change sleep positions according toan embodiment;

FIG. 4 illustrates a method for processing and analyzing the dataacquired by the position therapy device of FIG. 1 according to anembodiment.

FIG. 5 provides an illustration of the position therapy device accordingto an embodiment;

FIG. 6 shows the position therapy device worn around the neck accordingto an embodiment;

FIG. 7 shows the position therapy device worn on the back;

FIG. 8 uses a sample hypnogram to illustrate the clinical informationthat can be derived from accelerometers with the position therapy deviceand can be included in a position therapy report generated from datacollected by the position therapy device according to an embodiment;

and

FIG. 9 illustrates an alternative embodiment of the position therapydevice illustrated in FIG. 1 that includes a wireless transceiver.

DETAILED DESCRIPTION

Systems and methods for influence position of a user are provided.Embodiments can be used to control the influence the position of auser's body, and some embodiments can be used to influence a sleepingposition of the user. The device can be configured to be worn around thehead, the neck, or body of the user. The device can be configured toprovide feedback to a user if the user is sleeping or is positioned in atarget position to induce the user to change positions. For example, thedevice can be configured to limit the amount of time that the userspends sleeping in a supine position for users for whom it is notrecommended to sleep in a supine position, such as OSA patients andusers who are pregnant. The feedback can be provided by one or morehaptic motors that can be configured to provide various levels offeedback and the level of feedback can be customized based on the user'sreaction to the feedback.

According to one embodiment, a wearable position therapy device isprovided that is configured to monitor and store physiological signalsthat can be used to assess sleep quality and sleeping position of auser. The device can be worn around the head, the neck, or body of theuser. The device can be configured to provide haptic feedback to inducethe user change sleeping positions if the position therapy devicedetermines that the user is sleeping in a target position. In anembodiment, the form factor of the device is comfortable so as to notdisturb the user's ability to sleep while wearing the device. The deviceis also easy for a user to self-apply. The device can be configured toprovide feedback, including haptic feedback, to influence the user'ssleep positions. Adaptive feedback routines can be included to minimizethe disruption of sleep continuity while reducing the likelihood thatthe user does not return to the target sleep position. The applicationof feedback can be provisionally set so the device can worn to firstobtain baseline sleep data for comparison to the changes in sleepposition after initiation of feedback. The signals recorded during thenight(s) can be analyzed to assess parameters useful in assessingtreatment compliance and efficacy, such as total sleep time and sleepefficiency, snoring frequency and loudness, and percentage of sleep timeby position.

Embodiments of the position therapy device can also be used inapplications where the user is not sleeping but it is desirable for theuser to avoid specific positions. For example, a pregnant userexperiencing pre-eclampsia might be confined to bed rest by a physicianand instructed to avoid laying in a supine position when both asleep andawake in order to avoid aggravating the condition.

According to an embodiment, the target position can also be defined as aposition that the position therapy device will discourage the user frombeing in that position. In some embodiments, a set of allowablepositions can be defined and if the user moves to a position that is notincluded in the set of allowable positions that position can beconsidered a target position, and the position therapy device can beconfigured to provide feedback to the user to induce the user to changepositions to one of the allowed positions. This approach can be usefulin teaching or training exercises where the position therapy device canbe used to train a user to be in a certain position.

FIG. 1 is a block diagram identifying functional components and circuitsof a Position Therapy Device (“PTD”) 100 according to an embodiment. ThePTD 100 can be configured to be worn on the head, neck, or body of auser. In some embodiments, the PTD 100 can be worn during sleep toinfluence the position of the user's body. In other embodiments, the PTD100 can be worn while the user is awake to provide feedback to the userif the user positions his or her body in a predetermined target positionto be avoided. In an embodiment, the PTD 100 includes a microcontroller130, a haptic feedback device 140, power supply 150, battery 155,recharging circuit 160, and position detector 110. FIG. 1 illustratesthe various components of the PTD 100 as being in communication with oneanother. The components can be in communication with one another via awired or wireless connection.

The position detector 110 is configured to generate signal data that canbe analyzed by the PTD 100 to determine the sleeping position of theuser. For example, the position detector 110 can be used to determinewhether the user is in a supine position. According to an embodiment,the position detector 110 can comprise an accelerometer. According to analternative embodiment, a pressure switch or sensor can be used insteadof an accelerometer. When the PTD 100 is worn on the user's the neck oragainst the user's back, the pressure switch or sensor can be used todetect when the user is sleeping or laying in a supine position.

According to an embodiment, the PTD 100 can include a microphone 105that can be configured to capture audio data while the user is sleeping.This audio data can be analyzed by the PTD 100 to detect snoring and/orother audible symptoms that can be causing sleep disruption. Snoring canbe an indicator of obstructed breathing, and the PTD 100 can be used ina therapy regime for OSA in which a user is discouraged from sleeping ina supine position. In an example, microphone 105 can be used to captureaudio signals to assess snoring magnitude and frequency, which arelikely to be position dependent. In a preferred embodiment an acousticmicrophone is used to obtain quantified levels of snoring. In analternative embodiment, a vibration microphone can be used instead of anacoustic microphone. In an embodiment, the PTD 100 can be configured tocorrelate the audio data captured by microphone 105 with positional datagenerated by the position detector 110 to determine whether to providehaptic and/or audiovisual feedback to the user to induce the user toshift to a different sleep position. For example, a user having OSA canbe induced to sleep in a non-supine position if severe snoring isdetected by the PTD 100.

In the embodiment illustrated in FIG. 1 , the PTD 100 includes a powercomponent 160 that includes a rechargeable battery 155 and a powersupply 150 for receiving power from an external source for rechargingbattery 155 via recharging circuit 260 and/or powering the PTD 100. Thebattery 155 allows the PTD 100 to operate without requiring the PTD 100to be tethered to an external power cord or power supply, which could beinconvenient and uncomfortable for a user of the device. In thepreferred embodiment, the battery capacity is sufficient to allow thePTD 100 to acquire data from multiple nights while providing therequired haptic feedback to the user.

In one embodiment, battery 155 can be a rechargeable lithium polymerbattery.

According to other embodiments, battery 155 can be another type ofbattery, either rechargeable or non-rechargeable, and in someembodiments, battery 155 can be removable and replaceable. According toone embodiment, battery 155 is a rechargeable battery that includes amicro-USB connector that allows battery 155 to be recharged using astandard USB charger that plugs into an electrical outlet or a standardUSB host. In an embodiment, the recharging circuit 160 comprises astandard USB wall charger that plugs into a standard wall outlet inorder to power the PTD 100 and/or recharge battery 155 using mainspower. According to some embodiments, an external power supply can beused to power the device.

The PTD 100 can include a memory 170 for data storage. In an embodiment,the memory 170 can comprise a removable Multimedia Memory card (MMC) orSecure Digital card (SD) car or other types of removable persistentmemory. In another embodiment, the memory 170 can comprise a fixed flashchip. According to an embodiment, a data transfer interface 175 isprovided. According to an embodiment, the data transfer interface 175can comprise a micro-USB or similar type of connector that can be usedfacilitate downloading data from the PTD to an external computer systemor web portal, for uploading firmware executable by microcontroller 130to memory 170, or both. In an embodiment, the data transfer interface175 can also include a mechanical interface for providing power to therecharging component 160 to recharge the battery 155.

According to an embodiment, most commercially available microcontrollersor microprocessor 130 would be appropriate for the PTD 100. However, ina preferred embodiment, the microcontroller 130 is an inexpensive,small, low-powered chip. The PTD 100 can include firmware executable bythe microcontroller 130. The firmware can be stored in data storage 170or in a flash memory of microcontroller 130. According to someembodiments, the firmware can be updated by downloading new firmwarefrom an external computer system via data transfer interface 175.

According to an embodiment, the firmware can be configured to minimizethe power requirements of the microcontroller 130 while the PTD 100 isbeing used in recording mode to capture data from the position detector110, the microphone 105, and/or other sensors. The firmware can beconfigured to analyze data received from the position detector 110,microphone 105, and/or other sensors and to provide feedback to the userof the device via audiovisual output module 120 and/or haptic feedbackdevice 140 for providing tactile feedback to the user of the PTD 100. Inan embodiment, the haptic feedback device can comprise one or morehaptic motors for providing tactile feedback to the user of the PTD 100.In an embodiment, the PTD 100 can be configured to store variousposition therapy (PDT) data to the memory 170. The PDT data can includedata received from the position detector 110 and/or the microphone 105.The PDT data can include data, such as the sleep position at varioustimes, the changes to the sleep position of the user, sleep state andarousals, snoring data, and/or other data that can be recorded and/orgenerated by the PDT 100.

In an embodiment, the PTD 100 can be configured to store variousposition therapy (PDT) data to the memory 170. The PDT data can includedata received from the position detector 110 and/or the microphone 105.The PDT data can include data, such as the sleep position at varioustimes, the changes to the sleep position of the user, sleep state andarousals, snoring data, and/or other data that can be recorded and/orgenerated by the PDT 100.

According to an embodiment, the PTD 100 can be configured to write anaction history to the memory 170 to assist customer service support. Forexample, information regarding when the battery 155 of the PTD 100 hasbeen charged, when the device has been powered on and off, when thedevice has started and stopped recording sleep assessment data about theuser, and other information can be included in the action history thatis written to memory 170.

In an embodiment, the data transfer interface comprises a UniversalSerial Bus (USB) data transfer chip to facilitate transferring of datacaptured by the PTD 100 to an external computer system or web portal. Inanother embodiment, USB transfer capabilities can be incorporated intomicrocontroller 130.

The memory 170 can be used to store data collected by the PTD 100 whilethe device is being worn by a user. Alternatively, this information canbe stored to the flash of the microcontroller 130. To avoid data losswhen saving to flash memory, the firmware can identify when the batterypower is low and can conserve power until the data is downloaded.

In an embodiment, to improve the ease and speed of transfer of filesfrom the data storage device, a USB flash drive chip can be included inthe PTD 100. In some embodiments, the capability to transfer data viaUSB or native USB is provided by the microcontroller 130. According toan embodiment, the PTD 100 can be connected to an external computersystem via a USB connection, and the PTD 100 can be recognized as a USBHuman Interface device, which can allow direct control of the device bythe Microsoft Windows operating system and/or by Web-based software.

In an embodiment, the PTD 100 includes one or more haptic motors 140that can be configured to elicit vibrations in response to controlsignals from the to provide haptic feedback to the user when the PTD 100recognizes that the user is in the target position. The haptic feedbackcan be used to alert the user that the user needs to change positionsfrom the target position. In one embodiment, an electronic feedbackmodule that is configured to provide electrical stimulation to the userin response to control signals from the microcontroller can be usedinstead of haptic feedback in order to influence the sleep position ofthe user. In one embodiment, an audio emitter can used as an alternativeto or in addition to haptic feedback to influence sleep position.

According to an embodiment, in order to improve the ease of use of PTD100, audiovisual output module 120 can be used as a means to communicatewith the user. In one embodiment, voice messages can be provided via anaudio circuit or speaker to provide feedback to user. For example, avoice message might be provided to indicate that the PTD 100 has slippedout of position or has fallen off. In another example, a voice messagemight be provided to indicate that the battery 155 is low or that thePTD 100 is running out of memory for storing data. One skilled in theart will recognize that other types of audio messages can be provided touser of the device to facilitate use of the device. In an alternativeembodiment, an audio emitter can be used to project audio patterns thatthe user can be trained to recognize. For example, the audio emittercould be configured to emit a specific signal if the device is turned onor if the device has fallen off.

According to another embodiment, a light emitting diode (LED) can beused to identify when the PTD 100 is powered on, when the battery 155 isbeing charged, or alternatively when the battery 155 needs to berecharged, or when data is available for transfer from the PTD 100 orwhen data is being transferred from the PTD 100. In another embodiment,a display can be provided for displaying text messages, icons, or othervisual indicators to the user regarding the operation of usages of thedevice. For example, the PTD 100 can include a liquid crystal (LCD)display, an LED display, or an organic light emitting diode (OLED)display for displaying information to the user of the device. Oneskilled in the art will recognize that microcontroller and firmwareprovides the means to apply any number of notifications or feedbackusing various combinations audio and visual feedback.

According to an embodiment, the PTD 100 can comprise low profile chipsto minimize the profile of the PTD 100. For example, low profile chipscan be used to implement microcontroller 130, position detector 110(e.g., an accelerometer). In one embodiment, microcontroller 130, flashmemory for data storage 170, and a USB chip for data transfer interface175 can be mounted on a printed circuit board (PCB), and a triple-axisaccelerometer for position detector 110 can be centered on the top ofthe PCB. Connectors for battery 155, haptic motor 140, a mini-USBconnector for data transfer interface 175, light emitting diodes foraudiovisual output module 120, and an on-off switch can be mounted onthe bottom of the PCB. Passive components can be mounted in theavailable space around these components.

According to an embodiment, the on-off switch can be located where theuser can readily switch on the PTD 100, but the switch can besufficiently recessed so that the device cannot easily be inadvertentlyturned off during use (e.g., by catching the switch on bedding or apillow or the user's head or body). Because the haptic motor utilizescan use a substantial amount of current, the number of nights of use fora given size battery prior to recharging can depend on how often thehaptic motor is used to provide feedback to the user. In a preferredembodiment, haptic motor 140 is physically located within the enclosureof the PTD 100 such that the haptic motor 140 can transmit a maximumlevel of vibration with a minimal amount of power consumption.

FIG. 2 is a flow diagram of a method for using the PTD 100 to monitorand control the sleep position of a user according to an embodiment. Asdescribed above, the PTD 100 can be self-applied by a user and can bepositioned on the head, neck, or body and is worn by the user duringsleep.

Once the PTD 100 has been applied by the user, the PTD 100 can use a setof algorithms included in the firmware executed by microcontroller 130to assess data collected by the position detector 110 to assess thesleeping position of the user (step 210). According to an embodiment,the position detector 110 comprises one or more accelerometers that canbe used to assess the sleep position of the user. The PTD 100 monitorsdata received from the position detector 110 in order to make real-timeassessments of the sleep position of the user. As described above, thePTD 100 can also include a microphone 105 that can be used to captureaudio signals indicative of whether the user is snoring. In anembodiment, the audio data captured by microphone 105 can be analyzed bythe firmware to determine whether the user is snoring, and themicrocontroller 130 can write the data to data storage 170. In oneembodiment, the audio data captured by the microcontroller 130 can bewritten to the data storage 170 and the stored audio data can betransferred from the PTD 100 to an external computer system for furtheranalysis and processing. In some embodiments, the microcontroller 130can be configured to execute one or more analysis algorithms implementedin the firmware on the data received from the microphone 105 to identifywhether the user of the device is snoring. The microcontroller 130 canalso be configured to write snoring event data to the data storage 170,and the stored snoring event data can later be transferred to anexternal computer system or web portal for further analysis andprocessing.

A determination is made whether a target sleep position is detectedbased on the assessment of the data from the position detector 110 (step220). The target sleep position is a sleep position to be avoided. Forexample, the target sleep position for a patient with OSA may be asupine position, because sleeping on the back can cause the airway to besusceptible to collapse and can lead to inspiratory flow limitation. Ifthe target position is the supine position and the PTD 100 determinesthat the user is sleeping in the target position, the PTD 100 canprovide haptic feedback to the user (step 230) to influence the user'ssleep position. For example, if the user is sleeping in a supineposition and the target position is the supine position, haptic feedbackcan be provided to encourage the user to change position. According toan embodiment, haptic feedback can be elicited until the PTD 100 detectsthat the user h as changed position.

According to an embodiment, the PTD 100 can be worn for multiple nightsbetween battery charges and over the course of the multiple nights, thePTD 100 can monitor compliance, the impact of the feedback on sleepcontinuity, behavioral arousals and sleep efficacy, and snoring.

According to an embodiment, the method illustrated in FIG. 2 can beadapted for use with users who are using the PTD 100 while awake. Forexample, the PTD 100 can be used to assess the position of the user(step 210) who is awake and to determine whether the user is in a targetposition (step 220) and provide haptic feedback to the user (step 230).For example, the PTD 100 could be used by a pregnant user to warn theuser to avoid lying down in a supine position. In another example, thePTD 100 could be used to warn a patient with an arm or shoulder injuryfrom lying on the injured side of the body.

Alternatively, the PTD 100 can be used to assist a person locate oravoid the appropriate position. For example, the precise position of thehead, neck body or torso may be important for use in the rehabilitationof in injury. Haptic feedback can be used for positive reinforcementwhen a particular position is achieved, or for negative reinforcement,as described previously to avoid a particular position.

FIG. 9 illustrates an alternative embodiment of the position therapydevice illustrated in FIG. 1 that includes a wireless transceiver. Thewireless embodiment of the PTD 100 illustrated in FIG. 9 can be usedwith any of various methods described herein in which the non-wirelessversion of the PTD 100 can be used. The embodiment of PTD 100illustrated in FIG. 9 can remotely monitor the position of the user'sbody and provide haptic feedback to the user. The components of the PTD100 illustrated in FIG. 9 are similar to those of FIG. 1 , but theembodiment illustrated in FIG. 9 includes a wireless transceiver 980that can be configured to allow the PTD 100 to communicate with one moreremote position sensors 990. According to an embodiment, the wirelesstransceiver can be a Bluetooth transceiver, a Zigbee transceiver, orother type of wireless transceiver that can provide wirelesscommunications between the PTD 100 and the remote position sensor 990.FIG. 9 illustrates the various components of the PTD 100 as being incommunication with one another. The components can be in communicationwith one another via a wired or wireless connection.

The remote position sensor 990 includes a microcontroller 995, aposition sensor 993, and a wireless transceiver 997. In an embodiment,the microcontroller 995 can be similar to microcontroller 130 of PTD 100or can be of a different configuration. Position detector 993 can alsobe of a similar configuration as position detector 110 of PTD 100 or canbe of a different configuration. In an embodiment, the PTD 100 can alsoinclude the wireless position detector 110 when the remote positionsensor 990 is used, while in other embodiments, the PTD 100 can beconfigured to not include a wireless position sensor 110 when one ormore wireless position sensors 990 are used.

Information collected by the remote position sensor 990 can betransmitted to the PTD 100. The microcontroller 130 can use thisinformation to determine whether to generate a control signal to providehaptic feedback to the user with haptic feedback module 140.

In an embodiment, the remote sensor 990 can include a power supply 150,battery 155, and recharging circuit 160 similar to that of PTD 100. Inother embodiments, the remote sensor 990 can include a non-rechargeable,replaceable battery to provide power to the remote sensor.

In one embodiment, more than one remote position sensors 990 can be usedto provide information relating a position or positions of the head,torso, or extremities of a user. One skilled in the art will recognizethe potential benefit of an athlete having multiple remote positionsensors attached to key aspects of his body to ensure complex positionsare maintained prior to execution of an action (e.g., preparing to hit abaseball, drive or put a golf ball, shoot a free throw, etc.). Thisapproach allows for position information obtained during performancemodeling, video taping, etc. to be translated to positions or angles ofthe body or extremities and in which haptic feedback can be used toassist the user to achieve that exact position (or similar position)during practice without access to the more sophisticated measurementapproaches. In one embodiment the one or more remote sensors can beattached or woven into clothing, a glove(s), wristbands, socks, etc. toallow more accurate placement of the sensor relative to a part of theuser's body. In one embodiment, multiple remote sensors 990 can beattached or incorporated into a garment or accessory, allowing more thanone sensor to share use the same battery and/or transceiver. In oneembodiment, an energy-harvesting module can be used to provide power tothe battery of the remote sensor 990 and/or the PTD 100. Theenergy-harvesting module can generate power based on movements of theuser during the use of the PTD 100.

In an alternative embodiment, the remote sensor 990 can be connected tothe PTD 100 using a wired interface, and the PTD 100 and the remotesensor 990 can include appropriate physical interfaces for the wiredconnection. For example, in an embodiment, the remote sensor 990 and thePTD 100 can include data ports into which a data cable can be plugged toprovide a wired communication connection between the remote sensor 990and the PTD 100.

FIG. 3 illustrates another method for monitoring and influencing thesleep position of PTD 100 using conditional positional feedbackaccording to an embodiment. The method illustrated in FIG. 3 is similarto that of FIG. 2 , but the method illustrated in FIG. 3 is adapted toassist sleepers that have difficulty falling asleep in a position otherthan the target position. For example, the method illustrated in FIG. 3can be used to assist predominantly supine sleepers that may havedifficulty falling asleep on their sides by allowing the user toinitially fall asleep in a supine position. The method provides thepatient with an opportunity to fall asleep before using conditionalfeedback to influence the sleep position of the patient. This approachavoids compromising the sleep efficiency of the user by forcing the userto attempt to fall asleep in a non-target position when the user istypically unable to fall asleep in a non-target position. For example,if a user who is typically a supine sleeper will not be forced toattempt to fall asleep on her side.

As described above, the PTD 100 can be self-applied by a user and can bepositioned on the head, neck, or body and is worn by the user duringsleep. Once the PTD 100 has been applied by the user, the PTD 100 canuse a set of algorithms included in the firmware executed bymicrocontroller 130 to assess data collected by the position detector110 to assess the sleeping position of the user (step 305). Adetermination can then be made whether the user has had a sufficientamount of time in bed to make an assessment (step 310). In oneembodiment positional feedback will be initiated only after apredetermined or configurable elapsed time period with the PTD 100 on(e.g., 15-minutes). For example, in some embodiments, the user and/or adoctor or therapist treating the patient can configure the amount oftime that PTD 100 will wait before making an initial assessment, whilein other embodiments, the PTD 100 can be configured to wait for apredetermined time period before making an initial assessment. If theuser has not had a sufficient amount of time in bed prior to making anassessment, the method returns to step 305 where a new assessment can bemade.

Otherwise, if the predetermined or configurable time period has elapseda determination can be made whether movement is detected (step 320). Forexample, the user is moving his or her head or other parts of the body,then the user may still be awake. If movement is detected, the user islikely not to be asleep and positional feedback would not be effective.Therefore, the method returns to step 305 where a new assessment can bemade.

According to an embodiment, a user can reset the time period on the PTD100 if the user has trouble falling asleep. For example, a user might beawakened during the night by the need to use the bathroom, and uponreturning from the nocturnal use of the bathroom, the user can turn thePTD 100 off and then back on in order to reset the feedback delay.According to an embodiment, the microcontroller 130 can include areal-time clock that can be used to timestamp the on/off mark in thedata captured by the PTD 100 so that the data can be appended into asingle of information when a compliance and efficacy report is generatedfrom the data.

Otherwise, if no movement is detected, then the user is more likely tobe asleep, and a determination can be made whether snoring is detected(step 330). As described above, the PTD 100 can include a microphone 105that can be used to capture an audio signal that can be analyzed todetermine whether the user is snoring. While lack of snoring is notindicative of whether the user is asleep, snoring is indicative that theuser is asleep and can also be indicative of an airway susceptible tocollapse and can lead to inspiratory flow limitation. If no snoring isdetected, the user may not be sleeping, and thus positional feedbackcould be counterproductive. If the user is asleep and is not snoring,the user is likely to be in a non-target position (in this example, anon-supine position), and applying positional feedback might simply wakethe user. Otherwise, if the user is not asleep, applying positionalfeedback could prevent the user from falling asleep. Therefore, themethod returns to step 305 where a new assessment can be made.

According to an embodiment, step 330 can be optional if the user hassatisfied the conditions of steps 310 and 320 and has been in bed for asufficient amount of time and no movement has been detected. In someembodiments, the PTD 100 can be configured to track how much time haspassed since the movement was detected in step 320, and if apredetermined period of time has passed since the last movement wasdetected, the method can proceed to step 340 even if no snoring isdetected. For example, in one embodiment, if the user has been in bedfor at least 15 minutes, the condition of step 310 is satisfied. Nomovement is detected at step 320 so the step is also satisfied, but ifno snoring is detected, the method would return to step 305 even thoughtthe user might be asleep. Therefore, the PTD 100 can begin keeping trackof how long it has been since movement was last detected (or when step320 was first performed if no movement has been detected since themethod began), and if a predetermined time period (e.g., five minutes)passes an no movement is detected and no snoring is present, the methodcan proceed to step 340, because it is likely that the user is asleepbut is not snoring.

Furthermore, in an alternative embodiment, if snoring is detected evenif some movement is present, the snoring is indicative that the user isasleep, and the method can proceed to step 340. In yet anotherembodiment, the order of steps 320 and 330 can be reversed, so that thePTD 100 is configured to check for snoring before checking for usermovements.

A determination can be made whether the user is in a supine position forembodiments where the target position is a supine position (step 340).According to an embodiment, a determination could be made whether theuser is in other non-supine target positions depending upon theindividual needs of the user and the condition for which the user isbeing treated. If the user is in the target position, haptic feedbackcan be provided to the user (step 350). In a preferred embodiment, oncethe user is asleep, feedback is provided immediately after a positionchange so as to not alter or disrupt the continuity of sleep more thanwhat would normally occur when a sleeper changes position. In anembodiment, the position detector 110 can be used to detect that theuser has changed position. For example, in one embodiment, the positiondetector 110 comprises one or more accelerometers that can be used todetermine that the user's body position.

In one embodiment, the feedback stimulation routine begins at a lowintensity level two-second haptic feedback interval when the supineposition is detected. After applying the feedback to the user, anassessment can then be performed on data collected by the positiondetector 110 to assess the sleeping position of the user (step 360), anda determination can be made whether the user is in a supine position(step 370). According to an embodiment, if gross movement of the user'sbody position is not identified, an additional feedback routine sequencecan be applied. For example, in an embodiment, if the PTD 100 does notdetect that the patient has begun to change position within four secondsof the termination of the previous feedback routine, another 2 secondlong feedback routing can be presented at a higher intensity level thanthe previous feedback routine. According to an embodiment, the sequenceof steps 350, 360, and 370 can be repeated until the user finallychanges positions and settles into a non-supine position 370.

According to an embodiment, the PTD 100 can also be configured to storethe data received from the position detector 110 and the microphone 105(step 380). According to an embodiment, the data received by themicrophone 105 can be analyzed by the PTD 100 to determine whether theuser is snoring, and data indicating whether the user was snoring and aparticular data and time can be stored in the data storage 170.According to an embodiment, other data can also be collected by the PTD100 and stored in the data storage 170. For example, the PDT 100 canconfigured to determine a current sleep state of the user, a currentsleep position of the user, feedback that was provided to the user,and/or other information that can be used to determine the quality ofthe user's sleep and the efficacy of the PTD treatment.

According to an embodiment, the final intensity of the haptic feedbackprovided to the user that resulted in the user changing position can besaved to data storage 170 and can be used as a starting level for thehaptic feedback provided the next time that feedback is required. Thepatterns of haptic feedback described above are merely one example ofthe pattern of feedback that can be used to influence the sleeping ofthe user. In other embodiments, different patterns of haptic feedbackincluding different haptic feedback intervals and lengths of pausesbetween intervals of increasing intensity of feedback can be used.According to an embodiment, a different number of haptic motors 140 canalso be used to create a subjective perception of increased levels offeedback.

According to an embodiment, the firmware of PTD 100 can be configured tostore data representing the average feedback intensity levels and rangeof feedback intensity levels required to initiate position changes. Thisdata can be stored in data storage 170, and the PTD 100 can utilize thisinformation the next time the PTD 100 is used to establish the initialfeedback pattern. Thus, the patterns and intensity of the feedback canbe tailored to the individual user in order to encourage positionalbehavior without over-stimulation. For example, by using the techniquesdescribed above, the PTD 100 will not stimulate a light sleeper fullyawake, and the PTD 100 won't under stimulate a heavy sleeper, such thatthe feedback produced by the PTD 100 is ignored.

The feedback intensity is adaptive so that the therapy can also beefficacious in patients who are taking analgesic medications, sleepingpills, or consuming alcohol prior to bed. The conditional algorithms canaccommodate changes in the user's sensitivity to the feedback based onsleep stage or adaptation to continued use of the PTD 100. PTD 100 canbe configured to use various numbers of feedback intensity levels, aswell as various lengths of the feedback and durations between feedbackevents without negatively impacting the functionality of the PTD 100.

According to an embodiment, the position detector 110 compriseaccelerometers that are sensitive enough provide data that can be usedto monitor the breathing of the user. The breathing pattern of the usercan be collected as part of the position therapy data collected by thePTD 100 and can be used to identify interruptions and arousals in thesleep pattern of the user. For example, in an OSA patient, the patient'sbreathing can be interrupted resulting in the patient gasping for air.The data collected by the accelerometers can be analyzed to identifysuch events. The breathing data collected by the PTD 100 can also beused in determining whether the user is asleep, and can in someembodiments, be used in addition to or instead of the detection of usermovement in step 330. For example, the user's breathing pattern canchange when the user falls asleep and this change in breathing patterncan be identified in real time by monitoring and analyzing the signaldata from the accelerometer or accelerometers.

FIG. 4 illustrates a method for processing the data acquired by the PTD100. As described above with respect to FIGS. 2 and 3 , the PTD 100captures and stores data regarding the sleep state of the user (step405). In one embodiment, this data can be stored in the data storage 170of the PTD 100. The data acquired by the PTD 100 can be transferred toan external computer system or web portal (step 410) for additionalprocessing to assess various parameters useful in assessing complianceand efficacy (step 420). According to one embodiment, the data can betransferred from the PTD 100 using the data transfer interface 175. Asdescribed above the data transfer interface 175 can comprise a USBinterface for transferring the data acquired by the PTD 100 to anexternal computer system or a web portal.

The frequency of use of the PTD 100, based on hours per night and nightsper week can provide useful measures for assessing the user's compliancewith PTD therapy. Other data captured by the PTD 100, such as theresponse time to positional feedback and length of time, the number oftimes per night the patient attempts to sleep supine, the total andpercentage of time the patients user supine, and whether the user turnthe device off in the night to eliminate feedback can also provideuseful measures of treatment efficacy. According to an embodiment, thepositional signal data from position detector 110 of the can representactigraphic data. Actigraphy is a non-invasive method for monitoring therest and activity cycles of a patient. The PTD 100 can measure the motoractivity of the user and this data can be captured and stored by the PTD100 as part of the position therapy data. The motor activity data can beanalyzed to measure the behavioral sleep patterns of the user and sleepefficiency. This data can be incorporated into a position therapy reportgenerated for the user. In some embodiments, night to night differencesin the amplitude and frequency of snoring are additional measures whichcan also incorporated into a position therapy report to assist the useror their clinician assess the benefits of the PTD 100.

The external computer system or web portal can generate a report basedon the position therapy data collected and/or generated by the PTD 100.The position therapy report position therapy report can assist the useror a clinician to assess the benefits of the positional therapy regime.Once the report has been generated, the report can be downloaded orprinted (step 440) or viewed online. FIG. 8 is an example of a reportthat can be generated using the data captured by the PTD 100. Theexample report includes two graphs of data captured by the user deviceover time. The upper graph portion of the report includes positionaldata indicating the body position of the user over time. The lower graphillustrates the whether the user was awake or asleep over time andwhether the user experienced an arousal event. This report can bedownloaded for review by the patient or a clinician to assess theefficacy of the PTD therapy.

According to an embodiment, the PTD 100 can be interfaced with anexternal computer system or web portal to provide additionalcapabilities for monitoring treatment efficacy. For example, the PTD 100can be configured to record sleep position of the user without applyingfeedback for a predetermined number period of time, such as one or morenights, to create baseline information about the user's preference forsleeping positions and other sleeping habits. Once the baseline data hasbeen recorded, positional feedback can be initiated. The baseline datacan later be compared to data collected after positional feedback hasbeen initiated to determine whether the positional therapy is having anaffect on the user's sleep habits.

In some embodiments, the PTD 100 can be configured via a user interfaceprovided by the external computer system or web portal. For example, insome embodiments, the user interface is configured to allow the user toselect a sleep position that the user wishes to avoid. In an example,the user might configure the PTD 100 to avoid the supine position forOSA or for pregnancy, or non-supine sleep for patients with shoulder orarm injuries. According to an embodiment, the user interface can also beconfigured to allow the user or a clinician to configure otherparameters affecting haptic feedback or the algorithms used to make thevarious determinations described used in the method described above,such as the date and time.

FIG. 5 illustrates an example embodiment of the PTD 100. In theembodiment illustrated in FIG. 5 , the PTD 100 comprises a smallinjection-molded silicon enclosure 505. The silicon enclosure 505encapsulates the electronic components of the PTD 100 and the enclosureis thick enough to protect the electronic components. A thinner, morecomfortable durometer silicone can be used for the enclosure extensions510. In an embodiment, a thin strip of copper can be molded inside ofthe extensions to allow the PTD 100 to be adjusted to conform to theneck or back of the user and to decrease the likelihood that the PTD 100might accidentally be repositioned during sleep and result in falsepositive feedback. The silicone enclosure 505 and enclosure extensions510 can be easily cleaned and maintained with alcohol.

FIG. 6 illustrates the PTD 100 design illustrated in FIG. 5 that hasbeen placed around the neck of a user according to an embodiment. In theembodiment illustrated in FIG. 6 , a thin, round silicone enclosurestrap 610 holds the enclosure 605 of the PTD 100 in place round theuser's neck. The length of the left and right straps can be adjustedover the enclosure 605. According to an embodiment, a low profilemagnetic clasp (not shown), similar to that used in some wristbracelets, can be used on the front of the strap of the PTD 100 to allowthe PTD 100 to be easily applied or taken off by the user. According toan embodiment, to cover safety concerns regarding wearing a collarduring sleep, the strength of the magnet included in the magnetic claspcan be selected to ensure that the magnetic clasp will automaticallyrelease in the event that the PTD 100 were to get caught in the clothingof the user or the bedding.

FIG. 7 illustrates another embodiment of the PTD illustrated in FIGS. 5and 6 where the enclosure 705 can be worn over the spine and can be heldin place with the use of a longer, thicker enclosure strap 705 than isused in the embodiments illustrated in FIGS. 5 and 6 . The enclosurestrap wraps around the chest and over the shoulders of the user to holdthe PTD 100 in place.

Those of skill in the art will appreciate that the various illustrativemodules and method steps described in connection with the abovedescribed figures and the embodiments disclosed herein can often beimplemented as electronic hardware, software, firmware or combinationsof the foregoing. To clearly illustrate this interchangeability ofhardware and software, various illustrative modules and method stepshave been described above generally in terms of their functionality.Whether such functionality is implemented as hardware or softwaredepends upon the particular application and design constraints imposedon the overall system. Skilled persons can implement the describedfunctionality in varying ways for each particular application, but suchimplementation decisions should not be interpreted as causing adeparture from the scope of the invention. In addition, the grouping offunctions within a module or step is for ease of description. Specificfunctions can be moved from one module or step to another withoutdeparting from the invention.

Moreover, the various illustrative modules and method steps described inconnection with the embodiments disclosed herein can be implemented orperformed with hardware such as a general purpose processor, a digitalsignal processor (“DSP”), an application specific integrated circuit(“ASIC”), field programmable gate array (“FPGA”) or other programmablelogic device, discrete gate or transistor logic, discrete hardwarecomponents, or any combination thereof designed to perform the functionsdescribed herein. A general-purpose processor is hardware and can be amicroprocessor, but in the alternative, the processor can be anyhardware processor or controller, microcontroller. A processor can alsobe implemented as a combination of computing devices, for example, acombination of a DSP and a microprocessor, a plurality ofmicroprocessors, one or more microprocessors in conjunction with a DSPcore, or any other such configuration.

Additionally, the steps of a method or algorithm described in connectionwith the embodiments disclosed herein can be embodied directly inhardware, in a software module executed by a processor, or in acombination of the two. A software module can reside in computer orcontroller accessible on computer-readable storage media including RAMmemory, flash memory, ROM memory, EPROM memory, EEPROM memory,registers, hard disk, a removable disk, a CD-ROM, or any other form ofstorage medium including a network storage medium. An exemplary storagemedium can be coupled to the processor such the processor can readinformation from, and write information to, the storage medium. In thealternative, the storage medium can be integral to the processor. Theprocessor and the storage medium can also reside in an ASIC.

The above description of the disclosed embodiments is provided to enableany person skilled in the art to make or use the invention. Variousmodifications to these embodiments will be readily apparent to thoseskilled in the art, and the generic principles described herein can beapplied to other embodiments without departing from the spirit or scopeof the invention. Thus, it is to be understood that the description anddrawings presented herein represent exemplary embodiments of theinvention and are therefore representative of the subject matter whichis broadly contemplated by the present invention. It is furtherunderstood that the scope of the present invention fully encompassesother embodiments and that the scope of the present invention isaccordingly limited by nothing other than the appended claims.

What is claimed is:
 1. A method for providing position therapy to auser, the method comprising: receiving positional data from one or moreposition detectors of a wearable position therapy device while the useris wearing the wearable position therapy device; based on the positionaldata, determining whether the user is in a target position or one ormore non-target positions; when it is determined that the user is in thetarget position, generating feedback by one or more feedback generatorsof the wearable position therapy device to influence the user to changeto the one or more non-target positions; and generating a report of theposition therapy based on time spent in the target position and one ormore non-target positions.
 2. The method of claim 1 further comprisingproviding an assessment of the efficacy of the position therapy based onthe measure of time spent in the target and one or more non-targetpositions over a time period.
 3. The method of claim 1 wherein thedetermining whether the user is in the target position or one or morenon-target positions is determined over a time period.
 4. The method ofclaim 1, wherein the generating a report of the position therapy isbased on at least one additional measure.
 5. The method of claim 4,wherein the at least one additional measure comprises one or more of: anumber of changes in position that occur during use of the wearableposition therapy device, a total amount of time that the wearableposition therapy device is used, interruptions in sleep that occurduring use of the wearable position therapy device, a measure ofmovements that occur during use of the wearable position therapy device,an amount of feedback that was provided to the user by the wearableposition therapy device, a length of feedback delivered during use ofthe wearable position therapy device, the user's response time to thefeedback, a number of times that the user is in the target position, andefficacy based on one of a total time the user spends in the targetposition and a percentage of time spent in the target position.
 6. Themethod of claim 5, wherein, when the at least one additional measurecomprises interruptions in sleep, the method further comprisesdetermining the interruptions in sleep based on changes in position. 7.The method of claim 5, further comprising the wearable position therapydevice collecting the breathing pattern of the user and wherein theinterruptions in sleep are determined based on the collected breathingpattern of the user.
 8. The method of claim 4, further comprisingcapturing audio data and wherein the at least one additional measurecomprises a snoring frequency.
 9. The method of claim 8, wherein thereport is based on a relationship between one of snoring frequency andsnoring magnitude during the time spent in the target and non-targetpositions.
 10. The method of claim 1, further comprising, by thewearable position therapy device, transmitting information to anexternal system which provides an assessment of the efficacy of theposition therapy based on the time spent in the target and non-targetpositions, wherein the time spent in the target and non-target positionsis derived from the transmitted information.
 11. The method of claim 10,wherein generating the report of the position therapy comprises, by thewearable position therapy device, collecting positional data, withoutapplying feedback, to generate baseline data, wherein the report of theposition therapy is based on a comparison to the baseline data.
 12. Themethod of claim 11, wherein the comparison to the baseline datacomprises determining a difference between an amount of time spent inthe target position, with application of the feedback, and an amount oftime spent in the target position, without application of the feedback.13. The method of claim 11, wherein the comparison to the baseline datacomprises determining a difference between a number of attempts to be inthe target position, with application of the feedback, and a number ofattempts to be in the target position, without application of thefeedback.
 14. The method of claim 1, wherein providing feedbackcomprises adaptively increasing the feedback until the user changes tothe non-target position.
 15. The method of claim 14, wherein increasingthe feedback comprises one or more of increasing an intensity of thefeedback, increasing a length of the feedback, and decreasing a durationbetween feedback events.
 16. The method of claim 1, further comprising,by the wearable position therapy device, saving an action history tomemory, wherein the action history comprises one or more of when abattery of the wearable position therapy device has been charged, whenthe wearable position therapy device has been powered on or off, andwhen the wearable position therapy device has started and stoppedrecording positional data.
 17. The method of claim 1, further comprisingdelaying the feedback for at least a predetermined or configurable timeperiod.
 18. The method of claim 17, further comprising delaying thefeedback for longer than the time period when movement is detected afterthe time period has elapsed.
 19. The method of claim 17, furthercomprising delaying the feedback for longer than the time period whensnoring is not detected after the time period has elapsed.
 20. Themethod of claim 1, wherein the feedback is provided immediately after aposition change to the target position.
 21. The method of claim 1,wherein the feedback comprises audio feedback.
 22. The method of claim21, wherein the audio feedback comprises a voice message or audiopattern.
 23. The method of claim 1, wherein the position detector is aremote sensor that communicates wirelessly with a transceiver of thewearable position therapy device, and wherein a processor of thewearable position therapy device performs the determination of whetherthe user is in the target position or one or more non-target positions,and, when it is determined that the user is in the target position,generates a control signal for the feedback generator.
 24. The method ofclaim 1, wherein the at least one additional measure comprises apercentage of time the user was target.
 25. The method of claim 1,wherein the wearable position therapy device comprises a housing thatcontains a transceiver, a processor that generates a control signal forthe feedback generator, and a memory that stores position and feedbackinformation, and wherein the position detector comprises a remote sensoroutside the housing that wirelessly transmits the positional data to thetransceiver within the housing.
 26. The method of claim 1, wherein thepositional data comprises actigraphic data.
 27. A position therapydevice wearable by a user, the position therapy device comprising: atleast one position detector which generates positional data of the userwhile the user is wearing the position therapy device; at least onefeedback generator which generates feedback; and at least one processorcommunicatively coupled to the at least one position detector and the atleast one feedback generator, the at least one processor configured toexecute instructions stored in a memory to provide position therapy tothe user wearing the position therapy device by: receiving positionaldata from the at least one position detector while the user is wearingthe position therapy device, based on the positional data, determiningwhether the user is in a target position or one or more non-targetpositions, when it is determined that the user is in the targetposition, generating feedback by one or more feedback generators of thewearable position therapy device to influence the user to change to theone or more non-target positions, and generating a report of theposition therapy based on time spent in the target position and one ormore non-target positions.
 28. A wearable device for providing positiontherapy to a user while the device is worn by the user, the devicecomprising: one or more position detectors which generate positionaldata of the user while the user is wearing the device; one or morefeedback generators which generate feedback; and at least one processorcoupled to the one or more position detectors and one or more feedbackgenerators, the at least one processor configured to executeinstructions stored in a memory to influence the user to change positionfrom a target position to one or more non-target positions by:collecting positional data via the one or more position detectors whilethe user is wearing the wearable device, based on the positional data,determining whether the user is in the target position or one or morenon-target positions, and when it is determined that the user is in thetarget position, adaptively delivering feedback by increasing thefeedback generated by the one or more feedback generators until the userchanges to the one or more non-target positions.
 29. The wearable deviceof claim 28, wherein the at least one processor configured generate areport based on time spent in the target position and one or morenon-target positions.
 30. The wearable device of claim 28, whereinincreasing the feedback comprises one or more of increasing a number offeedback generators used after each of one or more time intervals,increasing an intensity of the generated feedback, increasing a lengthof the generated feedback, and decreasing duration between generatedfeedback events.
 31. The wearable device of claim 28, wherein the one ormore feedback generators comprises one or more haptic motors.
 32. Thewearable device of claim 28, wherein the one or more position detectorscomprises one or more accelerometers.